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NPI Code Detail

MEDICARE: ROSETTE ROSARIO MANIO MD

MEDICARE: ROSETTE ROSARIO MANIO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianG79542CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100G795420OTHERCAMEDI CAL

General Provider Information

NPI Number : 1043217292
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSETTE ROSARIO MANIO MD
Provider Business Mailing Address
First Line : 200 OCEANGATE
Second Line : SUITE 100
City : LONG BEACH
State : CA
Zip : 90802-4317
Country : US
Telephone Number : 562-499-6191
Fax Number : 877-469-3631
Provider Business Practice Location Address
First Line : 1900 ATLANTIC AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-5502
Country : US
Telephone Number : 562-437-0373
Fax Number : 877-469-3649
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2005
Last Update Date : 03/29/2017

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Directions to “ ROSETTE ROSARIO MANIO MD” Practice Location

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